FORM 1023-EZ for ETHYN ERIC MILLER MEMORIAL SCHOLARSHIP PROGRAM

Field Data
EIN 82-0913267
Case Number EO-2017090-000428
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ETHYN ERIC MILLER MEMORIAL SCHOLARSHIP PROGRAM
Organization’s Mailing Address 954 GRASSLICK RD
City RIPLEY
State WV
ZIP 25271
Accounting period End 12
Primary contact name KEVIN MILLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KEVIN MILLER
PRESIDENT
954 GRASSLICK ROAD
RIPLEY WV 25271

Officer/Director/Trustee Two

DENISE DAVIS
VICE-PRESIDENT
208 PELL STREET
GRANTSVILLE WV 26147

Officer/Director/Trustee Three

KRISTIN MILLER
SECRETARY/TREASURER
954 GRASSLICK ROAD
RIPLEY WV 25271

Organization’s website
Organization’s email EMILLER5@CASCABLE.NET
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/23/2017
Organization Incorporation State WV
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B82 - Scholarships, Student Financial Aid Services, Awards
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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